Prospective evaluation of a 3.1-mm battery-powered esophagoscope in screening for esophageal varices in cirrhotic patients

Madhotra, Ravi; Mokhashi, Mahesh; Willner, Ira; Hawes, Robert H.; Reuben, Adrian
April 2003
American Journal of Gastroenterology;Apr2003, Vol. 98 Issue 4, p807
Academic Journal
: ObjectiveStandard esophagogastroduodenoscopy (EGD) is costly and uses conscious sedation that cirrhotic patients may tolerate poorly. This study aimed to determine the feasibility and acceptance of unsedated esophagoscopy with an ultrathin battery-powered endoscope (BPE) in cirrhotic patients for diagnosing esophageal varices (EV).: MethodsWe first studied the prevalence of significant gastroduodenal pathology that could be missed if only esophagoscopy were performed in cirrhotic patients undergoing liver transplant evaluation. A prospective study was then done to evaluate a BPE in EV screening. Unsedated per-oral endoscopy was first done by a single endoscopist using a BPE, followed by EGD by a second endoscopist who was masked to the BPE result. A visual analog score was used to determine patient tolerance. Patients were asked about their preference for endoscopy in the future. A paired Student t test and the κ statistic were used in the statistical analysis.: ResultsIn the retrospective study, 199 patients were reviewed; three patients (1.5%) had gastric ulcers, and two patients (1%) had duodenal ulcers. In the prospective study, 28 cirrhotic patients (16 women) were evaluated. EV were diagnosed in 14 patients with a BPE, and 13 were confirmed by standard EGD (sensitivity and negative predictive value 100%, specificity and positive predictive value 93%, κ = 0.93). EV were graded as large in one and small in 13 patients with a BPE, but small varices diagnosed in one patient were not confirmed on EGD. Both procedures were well tolerated by all patients. Twenty-seven of 28 patients preferred unsedated endoscopy with a BPE over EGD.: ConclusionsUnsedated endoscopy with a BPE is safe and well tolerated. The diagnostic accuracy of a BPE for diagnosing EV is the same as by EGD. Esophagoscopy with a BPE is a potential alternative to EGD for EV screening.


Related Articles

  • Esophageal Ulceration Induced by Zidovudine. Edwards, Paul; Turner, Jennifer; Gold, Julian; Cooper, David A. // Annals of Internal Medicine;1/1/90, Vol. 112 Issue 1, p65 

    Reports the occurrence of nonspecific midesophageal ulceration in patients with AIDS who were taking zidovudine. Account of a related study; Possible causal link between ingestion of zidovudine capsules and esophageal ulceration; Implications for research.

  • A CASE OF ESOPHAGEAL PERFORATION DUE TO A PILL-INDUCED ULCER SUCCESSFULLY TREATED WITH CONSERVATIVE MEASURES. Yamaoka, Kazuaki; Takenawa, Hiroshi; Tajiri, Kazuo; Yamane, Michio; Kadowaki, Ken; Marumo, Fumiaki; Sato, Chifumi // American Journal of Gastroenterology;May1996, Vol. 91 Issue 5, p1044 

    Presents a case of esophageal perforation in a male patient due to a pill-induced ulcer. Causes of esophageal perforation; Medical analysis of the patient; Categories of medications implicated in esophageal injury.

  • BARRETT'S OESOPHAGUS: OESOPHAGEAL ADENOCARCINOMA INCIDENCE AND RISK FACTORS. Campbell, E.; Cooper, B. T.; Riley, S. A.; Trudgill, N. J. // Gut;Apr2004 Supplement 3, Vol. 53, pA27 

    Barrett's oesophagus (BO) is associated with the development of oesophageal adenocarcinoma (OA). However, recent evidence suggests many existing studies have been too small and overestimate the risk of OA. This article presents the largest follow up series of BO in England and examines the...

  • Surgery Not a Factor in Esophageal Cancer.  // Nutrition Health Review: The Consumer's Medical Journal;2003, Issue 88, p17 

    A study in the December 2001 issue of Gastroenterology reported that patients who have undergone stomach surgery are not at a higher risk for esophageal cancer. These results dispute the idea that when a patient undergoes surgery to remove part of the stomach, usually a result of gastric or...

  • SPONTANEOUS HEALING OF A CYTOMEGALOVIRUS ESOPHAGEAL ULCERATION IN A PATIENT WITH ACQUIRED IMMUNODEFICIENCY SYNDROME. Wilcox, C. Mel; Schwartz, David A. // American Journal of Gastroenterology;Dec1993, Vol. 88 Issue 12, p2111 

    Presents a case study involving a patient with Candida esophagitis and cytomegalovirus esophageal ulceration who had spontaneous healing of the esophageal ulcer without institution of antiviral or immune modulating agents. Drugs administered to the subject; Remission of infections and neoplasms...

  • Relationship of Chronic Ulcerative Esophagitis to Ulcerative Colitis. Christopher, Nicholas L.; Watson, David W.; Farber, Edward R. // Annals of Internal Medicine;May69, Vol. 70 Issue 5, p971 

    Focuses on a study that examined the relationship between esophagitis and ulcerative colitis. Methodology of the study; Results and discussion on the study.

  • What's Hot in the Red Journal This Month.  // American Journal of Gastroenterology;Nov2012, Vol. 107 Issue 11, p1599 

    An introduction is presented in which the editor discusses various reports within the issue on topics including Barrett's esophagus, ulcerative colitis, and Crohn's disease.

  • Clinical Quiz.  // Africa Health;May2014, Vol. 36 Issue 4, p44 

    A quiz concerning ulcer, gastric volvulus and Barrett's oesophagus is presented.

  • Oesophageal perforation due to paraquat. Ackrill, P.; Hasleton, P.S.; Ralston, A.J. // British Medical Journal;5/13/1978, Vol. 1 Issue 6122, p1252 

    The severe and often fatal effects of paraquat on the lungs and kidneys are well recognised. The corrosive effect on the upper alimentary tract mucosa has received less prominence. We report two cases of paraquat ingestion causing oesophageal ulceration and death from mediastinitis.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics